Interplay between triglyceride-glucose index, cardiometabolic risk, and premature/early-onset major adverse cardiovascular and cerebrovascular events.

The increasing prevalence of cardiovascular diseases (CVD) and type 2 diabetes, particularly among younger populations, highlights the urgent need for early, cost-effective risk assessment tools. The Triglyceride-Glucose (TyG) index, derived from routine triglyceride and glucose levels, has emerged as a reliable predictor of insulin resistance and is gaining recognition for its role in forecasting cardiovascular risk, including Major Adverse Cardiac and Cerebrovascular Events (MACCE). Unlike more complex and costly insulin resistance tests, the TyG index offers a simpler approach to early detection, particularly in individuals without obvious clinical signs of metabolic disease. This narrative review synthesizes evidence on the association between the TyG index and various cardiovascular outcomes, focusing on early-onset conditions such as atherosclerotic cardiovascular disease (ASCVD), myocardial infarction (MI), coronary artery disease (CAD), stroke, heart failure, and all-cause mortality. Notably, the TyG index has shown predictive value across diverse patient populations, including those free from diabetes or dyslipidemia.